but it doesn't go this much in depth. >> i think it would be good because it's part of our wellness program that we are working in conjunction with other agencies of the city to help support that and thank you. >> we have our own program and the city has the program built off the work done here . >> we'll do a follow up on another calendar date. >> any other questions of the director? any public comment? >> there are no public comment request. >> thank you, next item. >> next item is general public comment. i'm not receiving any request. would anyone like to make a comment? >> we've move on to the community and public health committee report back. he will report back on the

meeting. >> we covered two items today on healthy food and healthy eating initiative and happy to note the certified coalitions have come together to bring health y exercise and regards to repurposing stores, corner stores that do not have food we heard there were three that were repurposed in bayview and one in tenderloin and one in my district and two on the way. we have been very successful of repurposing these stores. it's not only the food chains but the infrastructure with regard to new equipment and food and supplies. we also heard about the needle exchange program which continues to

serve 18900 addicts in san francisco using iv drugs. it's been very important and very successful program. the only question i had was how this would link up with getting the zero program and that will be a program to link the iv needle program. >> thank you very much. questions to pating? is there any public comment? >> there were no request for this item. >> okay. >> next item. item 6 is the non-hospital employee recognition award. >> again it is the privilege

of the members of the commission to recognize staff who have performed their work in exemplary manner we have done that at general and laguna honda and we are giving those awards to those who are not within those institutions. it almost seems like 6,000 employees names are in here and i'm sure most of them deserve it. the first person who i think you just said was ill is michael baxter. so i'm sorry that he was not here. other achievements that the director didn't quite name, but i would name so we can recognize him so

we can present in absence, he cofounded the lark son clinic, the coal clinic, a founder and expanded services at the third street youth clinic. he expanded the youth guidance center medical clinic to incorporate mental health and primary care services. he founded the dimensions clinic focusing on lgbt youth at the castro youth health center and collaborated to expand the balboa teen clinic and wellness center into areas of mental health and health education. and he coauthored a comprehensive program for the san francisco

unified school district and the implementation of long acting reversible contraception for youth and young adults. clearly he is well deserving as being one of our outstanding employees and in absence, we will be presenting him this certificate. [ applause ] >> our next honoree is dwayne iron horn. is he here? [ applause ] in 2008, dwayne was assigned the director of the contract compliance and in a staff of 11. under his leadership he completed a corrective action practice to improve community based contractors with issues, a, an issue for our department.

this project has been so effective that the entire city adopted it and the office has been redesigned to be more effective and efficient cht mr.ion horn is an outstanding employee working together to integrate and has in fact been so successful that the programs businesses offices expanding to become the business office to ensure that monitoring practices are standardized and centralized across the department. we need this effort and in incredibly grateful for your efforts. [ applause ] >> please, come on up. [ applause ]

>> our next award is the ebola planning team. it's a large group of people. those who are here, could you please come up and stand with the team leader there, barbara garcia and mr. aragon. all of you please stand up so we can acknowledge all of you. [ applause ] on september 30, 2014, the cdc announced the first laboratory case confirmed of ebola diagnosed in the

united states and this prompted a local response in the nation. a planning teaming meeting was convened. there were three times as many people who were unable also to come here and we want to recognize all of you. who worked tirelessly hours to ensure this city has a coordinated and unified response of an vent of an ebola case. that included developing information and materials to educate the public, convening public meetings, communicating internally with our stall and externally on media request, assisting the airport in its preparedness. developing and executing ebola type exercises and establishing protocol and monitoring systems and

ensuring staffing supplies and needs for response and developing and conducting training, contracting with clean up companies to ensure environmental safety, keeping up to date the social awareness of the outbreak worldwide identifying negotiating locations for possible isolation in quarantine needs and collaborating with our partner agencies and cbo's. we know the word got out for ebola, we know the city felt it was prepared because of this team. thank you very much. [ applause ] >> please step forward so we can acknowledge all that are here. thank you. there is a photo op here. okay.

amika, please come forward. she provided analysis and staff report for the mayor's 2013 universal health

council. on july 2013, mayor asked her to include the stakeholders and data driven process to examine san francisco's implementation of the federal affordable care act and it's integration in our own health and security plan. the final report issued in january of this year. the topic was controversial and the ten adversarial. micka remained the focus was on the staff. micka help identified the key issues in order to do its work and draft the key issues. she planned with meeting and planning and evaluation of logistics. it was successful to its

success and certainly helped this commission through the issues. thank you very much, and congratulations a. [ applause ] >> our next award is to the jail information management design team and those who are part of that team, if they will also stand up.

let's go on the side with dr. golden stone who helped nominate them. we are glad that you are here and we would like to acknowledge all the work that you have done as we understand you are nearing retirement. the jail team, johnson, fred, rj and margaret and wesley straton. [ applause ] this team successfully helped to design, build and implement the jail services new and improved medical records system known as jim. this was also executed at no extra charge to the department. this helps the non-jail staff easier access to patient medical history housed in the county jails. it has a relational view

between the department's lcr and improves work flow and improves outcomes for the patient. an innovative best practice for jim now allows for drug interactions and drug allergy interactions that can be seen by the provider at the time of ordering resulting in decrease of adverse reactions to prescribed medications. because this is relational data base, it also gives our users the ability to develop and enhance the system without relying on a vendor to customize it. jail house is very fortunate to have the dedication and enthusiasm and knowledge from jane and fred to move the health from more

efficient jail information systems. >> kathleen shutin. come on up. [ cheers and applause ] >> always nice to have the crowd favorite go last. congratulations. kathleen is a public health nurse who coordinates care for the urban health clinic. most recently

kathleen worked to establish two community sites in the housing development and treasure island areas. each project helps the systems with services. kathleen managed both of these projects simultaneously while running existing shelter sites. she's often the sole clinician evaluating individuals. she serves patients whose needs fall during the scope of her practice. kathleen is a dedicated employee of whom we are very proud who truly cares about the integrity of her work and the communities to which she serves. [ cheers and applause ]

>> that was the staff in the back. i just want to acknowledge them. i think these are all wonderful examples of the type of work that all of our employees do. it makes this commission and this city very proud to have such a wonderful workforce and we congratulate everybody for all the work that they are doing on behalf of our city, on behalf of our patients. thank you very much. [ applause ] >> the next item on the agenda, commissioners is the palliative care task force report and the

resolution. >> good afternoon, i'm the deputy here. i wanted to briefly introduce the next item. this past summer a diverse group of stakeholders came together to discuss the need for palliative care, the increasing need for palliative care in san francisco. they represented different sectors and different populations but all had a shared interest in increasing the palliative care in san francisco. dph was happy to cosponsor the department of aging and adult services. dr. chow represented the committee on the task force. this is a final report which you are going to hear about today and we really benefited through the strong leadership of two cochairs and from the department of aging and adult services, the executive director there and dr. christine ritchie from uc sf.

before i turn it to them to lead you through the presentation, i want to also acknowledge two individuals who played a role in the development report that you have. one is monique parish who worked with the facilitation of the meeting and also pat il who supported this work of this task force as well. [ applause ] >> at this point i will turn it over to ann. >> i'm bringing this down just a little bit. good afternoon, president chow, commissioners, director garcia. it's a pleasure to be with you today to talk about and walk you through this report. we are going to start by looking at what the goals that were set for the group, talk a little bit

about process. i know commissioner sanchez in the past you have been interested in how we manage things to get done and implement them. we are going to set short and long-term goals and there was a resolution for your consideration at the end. i also in addition for introducing everyone, we have a number of people from the palliative care task force, if you can stand up, any who worked on it or part of it, thank you. nice to have so much support. i will have to tell you that palliative care is not an area of expertise for me. i have had experience with this kind of

work but never really under taken to understand what it meant professionally. so i had a lot of learning to do and thank goodness i was surrounded by people with dr. chow and dr. christine ritchie and who really understand this subject because professionally is what they do day in and day out. part of what the goal for this work was to bring people who have such expertise in this area with people like myself who actually touched the lives of many people in our world and i just say in home support alone we have 22,000 people and we have palliative care recipients. i had to figure out as much as i could and how to include the services. before you talk

about alzheimer's and dimension strategic plan and the coordinating council, this is a part of that work as well. we learned about an area we needed to learn about and new very little about and it was also an opportunity for people in the medical world to understand the work that goes on in the community outside of the hospital setting and pull people together so they can partner in the future, not just on implementing the recommendations that are in the report, but partnering together on a daily basis. so, a lot i think was learned from this work. there were obviously some goals we had when we started out and i understood over time that there is a growing need in this area and there are gaps in services because there are gaps in services about any place you look. although i think the jail house folks

caught my eye on that with all of their abilities there and what we realized there was no one place where we were gathering information related to palliative care. so if you were a community person or a provider of palliative care, you can go to do this research and know what else was going on in the community. yes, we don't have enough, but yes we have enough that people need to know about it. the task force was really and this basic i think really important in terms of being able to get the work done and the six sessions we had together. the group was people like us in the program and this is enormously important because the process itself was to do the work in each of these 3-hour meetings. i would wager to say that had it just been

executive directors we couldn't have done that, and at the same time it was important tools to manage people there who could move something forward because there were some great ideas. we really met in a very abbreviated period of time because at the very beginning we were not sure where the report would land in terms of it's recommendations moving forward. there was some thought from the mayor's office that maybe the council could play a role in this but it wasn't clear. the meetings were set and moved forward really fast and there was funding which came and the department of aging services

added dollars to cpmc. there were a number involved that helped push it forward. the task force itself, although we have a sense of a few goals we wanted to work on, we didn't really have it set in stone where we wanted to go. at first the meeting which is only a couple hours long pulling everybody from the room saying what do we want to accomplish in five meetings. what do we want to have at the end of this time. what do we want to be important to our community and have all of us as providers and most importantly help the folks who are recipients of this service. it was determined pretty quickly that if we focused on four areas, systems, quality, community engagement and financing that

we could probably cover quite a bit of area in a short period of time. i believe president chow, you were on the financing group, were you not? >> yes. >> i sat in on that one. i got to move around a bit and got a glimpse of information from what was going on. people self is selected into these groups. there was only one group with three people and came out with tremendous recommendations and did a tremendous amount of work. so you can see there was a lot of diversity, there was a lot of different ways that people went about doing the work but nonetheless you are going to see the recommendations from all the work groups. people expected from each of the groups and people had the ability to call on what people might know to share expertise as well. these are open meetings and community

people are very much welcomed to attend and participate. people who were not in the task force did participate and attend the different work groups. the three things that in that first meeting or so that we determined were important for us to focus on was first of all a definition of palliative care and i think we've all been in those kinds of discussions enough to know they can go on for a very long time. this was a topic and something we really did need to spend time and the nuance of it. there was a decision to create an inventory of what was going on in our community that could be shared and updated as we go forward and as i said earlier there were short and long-term goals that were

turned over as well. i think i will turn it to christine at this point. i want to call you dr. ritchie but i know you as christine. >> good afternoon, we appreciate your interest in this work. we wanted to spend some time talking about the definition of palliative care because it means different things to different people. first i wanted to make sure we are on the same page and that our definition of palliative care represents the community. we started with a definition early on in your presentation packet there. it was initiated by the world health organization and focuses on idea of family care and focuses on improving quality of life for those

with serious illness and should be provided at any stage or any age of the condition and should be provided concurrent with care so it's not an either or situation. it has to be disciplinary in nature in terms of the services and should be delivered in multiple settings. that's one of our issues that we have identified in san francisco is that we have palliative care in a lot of inpatient hospital settings but not so much in other settings of care. to amplify that, we have the task force and what we are doing in our community and wanted to emphasize that this care is not pro id by health care providers and it's provided by health care community, by others of the service organization, by members of the family and their community and there needs to be a holistic and comprehensive approach of thinking about the care and

the important part of that care is community and collaboration for all of those entities. again, emphasizing that this care is providing concurrently with care and not where people have to make decisions for or against palliative care and the emphasis should be on the patients dignity and peace and supporting family and their larger community and supporting the illness and throughout the process and at the time of death. this was about the population and we divided the population into short-term and long-term perspectives. long-term everybody should understand what palliative care and should be educated and we need to